Left Ventricular Ejection Fraction Assessed by a General Practitioner Using AI-Guided Point-of-Care Ultrasonography: Feasibility and Diagnostic Agreement With Conventional Echocardiography

Objective: The aim of this study was to assess whether a general practitioner (GP), without cardiac point-of-care ultrasonography (POCUS) experience, could feasibly and accurately estimate left ventricular ejection fraction (LVEF), using AI guidance in both image acquisition and interpretation. Materials and Methods: A feasibility study was conducted with adult patients who had undergone recent standard echocardiography. A GP used a handheld ultrasound device (GE HealthCare Vscan SL), connected to an iPad Mini (with Vscan Air app and Caption AI), to obtain cardiac images and use AI to assess LVEF. Feasibility was defined as successful image acquisition from a modified POCUS set of views involving apical four-chamber, apical two-chamber, and parasternal long-axis views. Diagnostic agreement was assessed against reference LVEF from a standard echocardiography. Results: Among 25 patients (median age 74 years, 52% male), all three views were successfully acquired in 76% of cases using a maximum examination time of 10 minutes. Median AI-POCUS LVEF was 50% (IQR: 43–55) compared to 48% (IQR: 42–53) by reference ( p = .14), with strong correlation (R = 0.95, 95% CI: 0.87–0.98). Bland–Altman analysis showed a mean difference of 1.0% (95% CI: –0.3 to 2.3), with acceptable agreement. Sensitivity and specificity for LVEF <50% were 90% (55.5–99.8) and 100% (66.4–100.0), respectively. Conclusion: AI-guided handheld cardiac ultrasound with a limited set of views for LVEF assessment may be feasible in a primary health care setting.